Characterization and outcomes of severe complications after autologous hematopoietic stem-cell transplantation: a retrospective multicenter study.

Authors

Corentin Le Cacheux, Mathilde Bastien, Aurélie Le Thuaut, Arthur Orieux, Léa Courtot-Melciolle, Muriel Picard, Mathilde Chanut, Frédéric Pène, Guillaume Dumas, Anne-Sophie Moreau, Quentin Quelven, Lara Zafrani, Emmanuel Canet

Published in

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. Volume 34. Issue 7. Jun 25, 2026. Epub Jun 25, 2026.

Abstract

To describe the clinical characteristics and management and to identify factors associated with outcomes of patients requiring intensive care unit (ICU) admission after autologous hematopoietic stem-cell transplantation (ASCT).
Multicenter retrospective observational cohort study.
Eight university-hospital ICUs in France between January 2013 and July 2023.
Consecutive adults (≥ 18 years) admitted to the ICU within 90 days following ASCT conditioning.
None.
Among 6,342 ASCT recipients, 355 (5.6%) required ICU admission. Most had malignant lymphoma (60%) or multiple myeloma (34.6%). Admission typically occurred during the aplastic phase (median, 13 days after conditioning). Sepsis was the predominant diagnosis (75.9%), with the most common sources being neutropenic enterocolitis (more common in lymphoma) and pneumonia (more common in myeloma). Vasopressors were required in 181 (51%) patients and invasive mechanical ventilation in 121 (34.1%) patients. ICU mortality was 13.5% (48 patients) and 90-day mortality was 23.9% (85 patients). By multivariable analysis, factors independently associated with 90-day mortality were higher SAPS II score, lower serum albumin, performance status score ≥ 2, and lymphoma as the underlying malignancy. At one year, 209 (58.9%) patients were alive and in remission, including 198 (94.7%) with a good performance status.
ICU admission was required for 5.6% of patients after ASCT, chiefly during the neutropenic period. Although organ support was often required, good short- and long-term outcomes were obtained, with most survivors achieving a sustained remission and functional recovery. The clinical profiles differed between patients with myeloma and those with lymphoma, and the latter had lower survival.

PMID:
42348046
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

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